1907 to World War II

On April 26, 1909, California became the third state of the United States to enact a sterilization law. This law allowed those labeled insane or feebleminded, as well as state prisoners to be sterilized and institutionalized. The way one was determined to be insane or feebleminded was very subjective: there was no “formula” or exact description of an insane or feebleminded person. Ultimately, if an individual was deemed unfit for society, he was at risk for sterilization. Initially, sterilization rates were quite low. For the first twelve years, only about twelve sterilizations were performed each year. In order to legally sterilize someone, two out of the three of the following had to approve the sterilization: · Superintendent or resident physician of the institution · Superintendent of the state hospital · Secretary of the State Board of Health Though standards for sterilization were relatively small, after 1909, the policy around sterilization would only become more and more broad. In 1913, a new sterilization law was enacted. Though this new law repealed the 1909 law, it essentially only added to the requirements to be considered worthy of sterilization. The 1913 law added guidelines to sterilize anyone “afflicted with hereditary insanity or incurable chronic mania or dementia.” This law was based on the premise that insanity was genetic. However, as stated before, there is no “formula” for determining if someone is insane. The 1913 law aimed to simply prevent those affected by insanity, feeblemindedness, chronic mania, and dementia from reproducing and having children. According to eugenics, if these unfit individuals would stop having children, then society would be better overall. In 1913, the State Lunacy Commission was added to the list of approval for sterilization. However, unlike the 1909 law that required two out of three supporters to follow through with the procedure, the State Lunacy Commission had ultimate power in deciding whether or not one should be sterilized. Again, the laws were expanded in 1917. The 1917 law concerning sterilization modified the 1913 law and added “all those suffering from perversion or marked departures from normal mentality or from disease of a syphilitic nature.” Although the wording is more complex, the 1917 law basically deemed everyone who seemed abnormal—in some way or form as determined by the State Lunacy Commission—unfit for society, and fit for sterilization. This law also shielded physicians from retaliation. This meant that even if the patient did not approve of the sterilization, the physician in charge of performing the procedure could not be blamed. This law also required the authorization by a Board of Trustees and a clinical psychologist with a Ph.D to perform the sterilization. Consent was not required by the individual or any family members. However, consent was often given anyway so that the sterilized individuals would be allowed to go leave the hospital. Often, the individuals were not told they were being sterilized. They were instead told that they could not go home until the procedure was complete.

Ann Cooper Hewitt and Forced Sterilization In 1934, Ann Cooper Hewitt's mother secretly requested that she be sterilized. Hewitt was advised to go to the hospital to get her appendix removed. During the procedure, not only did she receive an appendectomy, but she was also sterilized. She did not know that she was sterilized until over a year later. Ann Cooper Hewitt attempted to sue her mother, Dr. Tilton E. Tillman, and Samuel G. Boyd for performing sterilization without Hewitt's consent. This case brought up the question of constitutionality around sterilization in private practice with consent of the patient. At this time, there was no law that protected physicians who performed non-consented sterilizations in private practice, Judge Tuttle dismissed the case saying that the sterilization was perfectly legal since a guardian (Hewitt’s mother) requested the procedure. This resulted in the legal sterilizations to be widened to any individual whose parent decided that he or she “needed” to be sterilized.

Source: http://www.uvm.edu/~lkaelber/eugenics/CA/CA.html

With extremely broad requirements for “unfit,” sterilization rates began to rise dramatically. By 1921, 2558 sterilization had been performed in California alone. This number accounted for 80% of the sterilization cases nationwide. As seen in the above chart, the number of sterilizations increased dramatically. Prior to 1964, 20,108 sterilizations had been performed in both state psychiatric institutions and homes for the feebleminded. This accounted for one-third of sterilizations nation-wide. The majority of those sterilized were white, Mexican, and Mexican-American. In the 1920s, 15% of all those sterilized were Mexican. In the 1930s, this percentage rose to 21%. Adding African-Americans, Native Americans, Chinese, Japanese, and Puerto Ricans raised the percentage to 25%. More women were sterilized than men. Women were sterilized for reasons related to “sexual delinquency,” such as promiscuity or from being raped. Although the rape was not the woman’s fault, she was still considered feebleminded because of it. Men were also sterilized for “sexual delinquency,” but the sterilization was considered a benefit to the male.

Several institutions had been founded in California: Human Betterment Foundation, Sacramento’s Eugenics Society of Northern California, San Francisco’s Commonwealth Club and many prestigious universities such as University of Southern California taught eugenics in classrooms. These societies promoted sterilizations for the “socially inadequate.” F.W. Hatch, the secretary of the State Lunacy Commission, stated that sterilization would improve the individual’s “physical, mental, or moral condition.” Again, the premise of eugenics lies on a subjective view of what is fit for society.

California was the leader in eugenics and sterilization in the entire world. Despite the Great Depression beginning in 1929, sterilization rates did not decrease. In the 1930s, Germany admired California and her efforts to create the perfect society, free of all unfit individuals. Harry Laughlin, a leading American eugenicist remarks, “California must be given the credit for making the most use of her sterilization laws.” American eugenicists, such as Laughlin, and German eugenicists often discussed eugenic ideology. In 1936, Laughlin received an honorary degree from Heidelberg University for his work in eugenics. In 1939, the beginning of World War II, sterilization reached its peak annual rates. During World War II, sterilization rates stayed high, but the revelation of Hitler’s extreme eugenics movement, the Holocaust, changed the opinion around sterilization. The study of eugenics became very underground, out of fear that California would be connected to, and indirectly the cause of the Holocaust. This fear caused further regulation of sterilization post-World War II.

Post-World War II to 1970s

After the United States had returned from World War II and was in the process of recovering from the aftermath of the war, the number of sterilizations performed in California would never match the high numbers from earlier in the century. According to the statistics about sterilizations in California, from the start of the eugenics movement to the 1940s, the rate at which the total number of these surgeries gradually decreased until the numbers dwindled down to about a few hundred operations a year. It is quite possible to say that fear of any connection to ruthless killing by the Nazis in World War II and California’s eugenics movement served to be a pivotal factor that steered direction towards the enforcement of stricter laws about sterilizations. As a way of recovering from its losses in World War II, the government of the United States most likely needed to regrow its population and therefore changed laws to allow for more offspring.

Although the association with Germany did play a role in the decline of sterilizations, the Garcia vs. State Department trial in 1951 affected the specific changes in legislation. The debate about whether or not it was justified for patients living in state hospitals to only be discharged if they consented to sterilization sparked a change in eugenics law. The government wanted patients to have the opportunity to fight against sterilizations. In 1951, the state government of California required for full patient authorization before the doctor could perform the invasive surgery on the individual. Consequently, this pass in legislation made it more difficult for physicians to approve the sterilizations. Stricter requirements brought about more nuisances for the doctors and discouraged them from carrying out the procedures with as much ease as they did before. As a result, the number of sterilizations performed in 1951 dropped dramatically to 255 operations. Within the next few years, the numbers continued to decrease as more rules were enforced about sterilization. Many aspects of the law were being changed, including the removal of “idiots” and “fools” from use in regulation. All these modifications resulted from the realization about the true magnitude about forced sterilizations and ultimately saved more people in California from having their reproductive rights stripped away.With adjustments to legal sterilizations, the factors determining whether or not an individual should receive the surgery shifted from a focus on intelligence and supposedly inherited traits to a focus on one’s ability to take care of children. Despite the initial efforts to change the way of eugenics, postwar eugenicists realized that any traits of an individual, favorable or unfavorable, could actually reappear in later generations. This fact interested the eugenicists once again and influenced them to activate groups including Population Council, Population Reference Bureau, and Planned Parenthood. If they could not prevent those unfit from having offspring, these eugenicists looked for alternative methods to have a sense of control about the condition of the population. In the 1950s and 1960s, emphasis on family planning and the legalization of voluntary sterilizations for birth control escalated the number of reproductive surgeries being performed. This opened opportunities for women to be forced into giving consent to sterilization that they did not want. Eugenicists found this as a way to solve the social problems of poverty and illegitimacy. The use of signed forms allowed doctors to pass through with their surgeries without trouble. Mexican, African American, Native American women were the victims of this time period. People were sentenced to sterilizations when the government decided to deem them “unfit.”

US Birth Rate 1909 - 2009: This graph indicates the number of births per thousand people in the United States. The red marks the time period of the baby boom. Source: United States Census Bureau

Cases:Nancy HernandezWithin the time period of 1960 to the 1970s, cases like that of Nancy Hernandez, demonstrated examples of coerced sterilization by unjust means. In 1966, Santa Barbara Municipal Court Judge Frank P. Kearney charged Hernandez with a misdemeanor because she was found in a room that had marijuana. She lived with her boyfriend, who was a drug dealer, as well as her daughter. Even though she herself was not taking the drugs and there was no evidence to incriminate her, except for the fact that she lived in a drug dealer’s house, the judge was not in her favor. She only had the choice of probation and sterilization or prison for six months. Judge Kearney made it almost inevitable for Hernandez to choose sterilization. Regardless of her decision, Hernandez was sentenced to jail for three months because her friends and family had tried to defend her. Judge Kearney found reason in his jurisdiction because he thought that the lifestyle Hernandez lived would lead to a crime-filled and immoral future. Hernandez was unjustifiably judged and unfairly given limited options for her case.Minnie Lee and Mary Alice Relf However some cases, including the lawsuit in 1973 about two African American sisters Minnie Lee and Mary Alice Relf, exposed the injustice of sterilization to the world and caused more investigation in consideration of other sterilized victims. The parents of these two sisters created a lawsuit because they had been forced to approve of reproductive surgeries for their daughters. According to their story, the parents thought that they had consented to a birth control experiment for their daughters rather than sterilizations. They were unaware that the hospital, with the help of federal money, instead decided to perform reproductive surgeries on their two daughters. This case received national attention and led to a discovery of over 100,000 other victims who were sterilized against their will by federally funded programs. More and more people began to open up about their own experience and demonstrated a dire need for the government to improve regulations. These cases caused more laws to be changed so that this same type of injustice, which had previously been kept under the radar, would not happen again in the future.

The Population Bomb: Throughout the eugenics movement in California, population control was one of the main reasons that sterilization was coerced.

1970s to Present Day

Since the early 1970’s, the performances of sterilizations have become drastically rare in California; however, controversy over this practice still exists. The state has not explained how and why these injustices happened nor has it made an effort to compensate victims and their families. In fact, the state of California did not apologize for sterilizations until recently. Governor Gray Davis expressed an apology for sterilizations in 2003 and additionally repealed the law that originally allowed for forced sterilization. Another measure taken by the state is Senate Resolution Number 20. This recognized and expressed regret for the practice of Eugenics in June of 2003. It begins by outlining the purpose and describing the massive extent of the Eugenics movement. The resolution continues to express that human rights and dignity must be honored regardless of differences.Secretary of State, who is a prominent national figure, signed the resolution, thus making this apology a significant one as it demonstrates a greater initiative to improve government accountability. Despite all of California’s efforts to ban sterilization, it still occurred in the late 1970s. Specifically, many federal family planning institutions forced women to consent to unwanted sterilizations as a form of birth control. They thought sterilizations solved issues such as poverty and over population. In other words, eugenics was a way for the state to shape society in its image. California was promoting the practice because it was still blinded by prejudices towards people with certain traits. Although physicians had consent forms from women, most of these signatures were attained coercively. For this reason, it only seemed that sterilizations were practiced with the wide spread of approval of the population, but in reality people were in fact forced to consent.

An example of these coercive activities is the case of Madrigal v. Quilligan. In May of 1968, ten sterilized women filed lawsuits against their obstetricians at University of Southern California Los Angeles Country General Hospital. These individuals believed that their constitutional right to bare children was violated because they were coerced into approving reproductive surgeries. The stories of these women were very similar because all of their consent forms were signed while enduring the pain of childbirth, which clouded their judgment. For example, their lawyers stated that the women were not fully informed about the procedures because of their mental state. Additionally these women were Spanish speakers, and language barriers prevented full disclosure between patients and their medical caretakers. Once again this reaffirms the state’s immoral obsession over controlling the size of the population. Statistics confirm this conspiracy that occurred in hospitals. From July 1968 to July 1970, elective hysterectomies increased by 742%, and elective tubal ligations increased by 470%. These numbers represent the result of physicians' lies to women who were coerced into sterilizations. Additionally, they were not reporting the truth of their practice either. Ultimately the ten plaintiffs, all of whom were women, lost the trial because the court ruled that it was just miscommunication between the patients and the doctors. However, this had important implications for the future because in 1974, it became required that all state hospitals must change their behavior. For example, hospitals were required to provide bilingual consent forms and wait 72 hours before performing operations.

Protest against forced sterilization in the case of Madrigal v. Quilligan. at University of Southern California Los Angeles Country General Hospital in 1974.
Source: US National Library of Medicine

In modern day California, this history and dark legacy of coerced sterilizations still linger in federal propositions and legislations. For example, Proposition 187 was passed with a majority of votes in 1994 and restricted services to illegal aliens. Its intent was to prevent illegal Mexican immigrants from giving birth to children who cannot be deported. This is reminiscent of Eugenics in modern day California. For example, the state was trying to control the type of people that composed the population by excluding illegal immigrants and their offspring from society and portraying them as threats to the economy. But, the important aspect of this case is to show that the state’s attitude towards sterilization might be changing; this proposition was ruled unconstitutional in 1998.

There are many cases in present day California that demonstrate the unfairness of sterilizations. Although not to the same extent as eugenics, abortion was encouraged for pregnant mothers whose fetuses were pre-diagnosed with Down syndrome and other physical and mental disabilities. One of these cases includes a 2006 account of a woman, D.A. Marullo, who gave birth to a baby with Down syndrome in Southern California. D.A. Marullo was pregnant at the age of 44 when her doctor advised her to abort her child due to the large possibility of birth defects. D.A. Marullo was determined to have her baby and had no intention of terminating the pregnancy. However, the physician told her that she would regret her choice, but she decided to continue with the pregnancy. This event makes evident that people are stilled preoccupied with perfecting the population. D.A. Marullo even goes as far to it as “this whole world was crazy and as unfeeling as a group of Nazis” (Marullo, 76). A few months later when her baby was born, it was in fact diagnosed with trisomy 21- Down syndrome and was dangerously under five pounds.

The account of D.A. Marullo is significant because it demonstrates how even in modern day California, Eugenics is still practiced subconsciously. Physicians in society still promote aborting babies if they believe the baby will not fit into society or face problems when growing up. However, because D.A. Marullo still placed immense value on this possibly degenerate human life, it suggests that these beliefs that stigmatize disabled people can be overcome. This is relevant to today’s society because everyday education emphasizes the importance of establishing standards as a benchmark for society. People are expected to live up to these standards and thus, conform to society’s notion of being “fit.” Consequently, those that are considered the “other” are inevitably looked down upon or marginalized by our society.With the slowing occurrence of sterilization and eugenics, the demographics of California will change. Specifically, the ethnic composition will be altered. It is said that, in short time whites will no longer make up the majority of the population. This also implies that it is more likely that individuals who are diagnosed with Down syndrome or other disabilities will be accepted by society. By having a better grasp and critique of the prejudices derived from Eugenics and sterilization, people can be more accepting of those with disabilities in the future.